After suffering kidney failure, gallstones, uterine cancer and a heart attack, all in one year, Hilda Ellison needed a cane to get around, had trouble with stairs and was nervous about going down her front walk without holding onto someone.
Her adult children pleaded with her to move in with them. But Ellison, who's in her 70s, had lived in her Allendale home for a decade and she wasn't moving. .
"This is my home and I love it," Ellison said.
A growing number of seniors are choosing not to part with their homes, a decision that's making waves in the housing market by reducing the inventory of homes available for sale and helping push up prices.
Roughly three-quarters of people age 80 and older still live in their own homes, according to researchers at Harvard University. And, according to a survey by AARP, baby boomers will follow the trend their elders are setting — a 2014 survey by the organization estimated that 87 percent of adults over age 65 want to remain in their homes as they age.
In part because people are delaying selling their homes, the inventory of homes for sale is at a historic low in the Baltimore area and across the country. June marked the 21st consecutive month of declining home inventory in the Baltimore area, as the number of available homes dropped 12.6 percent from the year before.
There's more to the trend than older homeowners. People used to sell their homes every 10 years or so, said Jon Coile, board chairman for Bright MLS, a regional real estate listing service. These days, he said, people are waiting 12 or 13 years before selling. "That's making it more of a challenge for people who are not part of the system yet. There's less to choose from."
Drawn-out homeownership is only one factor contributing to the tight inventory, and homeowners may be holding onto their property for a number of reasons. Many are waiting for their homes to recover from pre-recession prices. The tight inventory is contributing to rising prices.
But as home prices slowly rebound, the rising trend of aging in place — and a growing economy of businesses and services enabling seniors to stay put — could pinch the housing market for years to come.
"This is on everybody's topic list," said Alyssia Essig, president-elect of the Greater Baltimore Board of Realtors. "We are healthier far longer, we're working longer and everyone wants their independence."
Ultimately, she said, "that is going to put a crunch on housing."
As technology and medical advancements enable more people to live at home into advanced age, the global home health care market is expected to balloon to nearly $350 billion by 2020, up from $227.5 billion in 2015, according to an industry analysis by research firm MarketsandMarkets.
But living at home longer isn't just about getting the right medical care. Seniors need help maintaining their homes and making improvements to accommodate their health needs.
At Ellison's home, researchers from the Johns Hopkins School of Nursing installed brighter lights and non-slip grips under her rugs to reduce the possibility of tripping. They added a grab bar in her bathroom to help her get out of the tub and installed a rail along her front walkway so she can get to and from her car.
Hopkins' CAPABLE study — short for Community Aging in Place - Advancing Better Living for Elders — also works with participants to teach them how to track their vital signs, establish a routine for taking medication and manage chronic conditions. The study, which is open to low-income seniors, tracks whether handyman repairs and better at-home health education can improve the overall health of people aging in place.
Ellison found out about the study through a connection at Hopkins, where she used to work.
"It's not just that they brought me things," Ellison said. "It's that they taught me how to use them."
Housing Upgrades to Benefit Seniors, a program administered by Baltimore nonprofit Civic Works, provides home repairs, such as fixing trip hazards, to improve safety at the homes of low-income seniors. The organization works with other community groups to send case workers and home repair teams to clients' homes.
For many of the program's clients, staying in their home is a point of pride, especially for minorities who may have struggled to obtain a mortgage decades ago, said Danielle R. Bouchard, who organizes the program for Strong City Baltimore, a neighborhood revitalization group.
"To have to give it up to move into a senior home, it's like, 'Well, what did I work for my whole life?' " Bouchard said.
That's the case for Jean Sherrod.
Her home in Better Waverly, where she moved with her husband in 1986, is the first she ever owned. Civic Works has made minor repairs there, and Bouchard routinely stops by to see how she's doing.
"I've considered it, I have," Sherrod said of selling the place. "But it would take so much."
Aside from her sentimental attachment to the rowhome, Sherrod takes care of her grandchildren and doesn't think she could afford to pay rent somewhere else.
"That decision to sell becomes tougher when you have all these connections and there may not be other options for you," said Rodney Harrell, a housing expert for AARP. "You may find this place doesn't work for you, but you're not sure if you can sell it and find another place that meets your needs."
A dearth of affordable senior housing also keeps people in their homes longer, especially if their property won't fetch a price that will give them much to support their move, said Laura N. Gitlin, a professor at the Johns Hopkins School of Nursing and director of its Center for Innovative Care in Aging.
"The huge elephant in the room is what are the housing options?" Gitlin said. "For many people the options are very poor because of personal finances and the housing stock available."
Existing rowhomes, condos and apartments often are unsuitable for seniors who need wide doorways for wheelchairs and walkers, and who could trip over doorway thresholds.
New-build housing is more likely to include amenities such as walk-in showers and tubs, handicap-accessible doorways and lower light switches, but it is often too expensive for seniors on fixed monthly budgets, Gitlin said.
"We have the potential of having some very creative options," she said, "but making the price point affordable and accessible remains a big challenge."
In the meantime, house-hunting millennials find slim pickings for sale.
Ross Hackett, 25, went to about a dozen homes with his real estate agent during the first few weeks of his search this spring.
After seeing everything on the market that came close to his admittedly detailed wish list, Hackett settled in to wait for the right house to come along.
"When it came down to the neighborhood I was interested in and features, there was not a plethora of homes that met my criteria," said Hackett, who works for Live Baltimore, which promotes home-buying in the city.
He eventually found a place that fit the bill, a Waverly rowhouse with a front porch, spacious backyard and updated kitchen, and expects to close on the sale later in July.
Many first-time home buyers are after "move-in ready" homes, such as the one Hackett bought, which adds to the challenge for seniors when they ultimately decide — or are forced — to sell a home that they have had difficulty maintaining, said Essig, the real estate agent.
"I find that younger buyers, they have HGTV-itis — if it's not perfect they won't buy it or they want to lowball the offer," she said. "It's creating frustration with the senior community. They're like, 'Well, why bother?' "
Though Ellison thinks it's the greatest home improvement ever, the black metal rail leading from her front steps to the sidewalk probably isn't the type of amenity that will appeal to buyers one day.
No matter, Ellison says. She doesn't plan on selling.
"I'll give it to my grandchildren," she said. "I would never sell my house."